21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

Abstract

Background Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints. Methods PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic). Results Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology (n = 162), Microbiology and Infectious Diseases (n = 36), and Emergency and Trauma (n = 26). Discussion The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks). Limitations This was a retrospective systematic review of heterogeneous reports which may only reflect a small proportion of true prevalence rates in the population.